颏下动脉岛状皮瓣联合负压封闭引流技术修复咽部恶性肿瘤术后咽瘘一例

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2017年12月临汾市中心医院烧伤整形科收治1例64岁男性喉癌术后咽瘘患者,患者咽部皮肤软组织类圆形缺损,直径约2.5 cm,形成咽瘘。分两次手术对其进行修复。一期手术中设计并切取颏下动脉岛状皮瓣,将皮瓣翻转180°后形成衬里,通过瓦合及嵌合技术,增加皮瓣与瘘口周缘的贴附面积,封闭瘘口,继发创面予负压封闭引流技术吸引治疗。二期手术植皮封闭创面,患者瘘口得到完全修复。术后随访2年,咽瘘无复发,供区隐蔽,外形良好,患者能经口进食,借助电子喉可以部分恢复发音功能,修复效果良好。“,”In December 2017, a 64-year-old male patient with pharyngeal fistula was treated in the Department of Burns and Plastic Surgery, Linfen Central Hospital. The patient had pharynx skin soft tissue-like round defects. The patient received two operations, including the submental artery island flap is turned over to form a lining, seal the fistula, and treat the secondary wound with VSD vacuum suction and skin grafting to seal the wound. After 2 years of follow-up, there was no recurrence of the pharyngeal fistula, the donor site was well concealed, and the patient couldoral feeding. With the help of the electronic larynx, the vocal function was partially restored, and the repair effect was good.
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目的基于技术-组织-环境模型(technology-organization-environment, TOE)和计划行为理论(theory of planned behavior, TPB),构建理论模型,探究医联体内临床医生肝脏超声造影技术采纳意愿的影响因素。方法2019年2—8月,通过自制量表,对福建、江西两省4个医联体内肝病诊疗相关科室的临床医生进行问卷调查。采用Amos 24.0建立结构